糖尿病患者肌少症的风险和决定因素：来自卡塔尔生物库队列的病例对照研究。
Risk and determinants of sarcopenia in people with diabetes: a case-control study from Qatar Biobank cohort.
机构信息
Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Doha, Qatar.
National Institute of Public Health, Clinical Epidemiology, and Toxicology-Lebanon (INSPECT-LB), Beirut, Lebanon.
出版信息
BMC Endocr Disord. 2024 Sep 30;24(1):205. doi: 10.1186/s12902-024-01722-1.
BACKGROUND
Diabetes is associated with impairments in muscle mass and quality increasing the risk of sarcopenia. Thus, this study aimed to investigate the odds of sarcopenia and its associated risk factors among Qatari adults (> 18 years), while exploring the modulating effects of health and lifestyle factors.
METHODS
Using a case-control design, data from 767 participants (481 cases with diabetes and 286 controls without diabetes) was collected from Qatar Biobank (QBB). Sociodemographic, lifestyle factors including dietary intake, anthropometric and biochemical measures were analyzed. Handgrip strength, Dual X-ray absorptiometry (DXA), and Bio-impedance were used to assess muscle strength, muscle mass and muscle quality, respectively. The risk of sarcopenia was estimated using the European consensus on definition and diagnosis of sarcopenia.
RESULTS
Cases with diabetes were older (55 vs. 36 years; P < 0.001), had higher BMI (31.6 vs. 28.3 kg/m2; P < 0.001), lower cardiorespiratory fitness (50.0% "Moderate" fitness for cases, 62.9% "High" fitness for controls), and consumed less total (59.0 vs. 64.0; P = 0.004) and animal protein (39.0 vs. 42.0; P = 0.001), compared to controls based on a computed score. Participants with diabetes also had lower appendicular lean mass/BMI, handgrip strength, and higher probability of sarcopenia/probable sarcopenia (P < 0.005). Adjusted multiple logistic regression revealed that elevated cardiorespiratory fitness (β = 0.299, 95%CI:0.12-0.74) and blood triglycerides (β = 1.475, 95% CI: 1.024-2.124), as well as being a female (β = 0.086, 95%CI: 0.026-0.288) and having higher BMI (β = 0.908, 95%CI: 0.852-0.967) and ALM/BMI (β = 0.000, 95% CI: 0.000-0.007) are independent predictors (p < 0.05) of sarcopenia risk.
CONCLUSIONS
This study highlights the intricate relationship between diabetes and sarcopenia, revealing modifiable risk factors. Individuals with diabetes were found to have a higher likelihood of sarcopenia, which was associated with lower fitness levels and higher blood triglycerides. Protective factors against sarcopenia included being female and having higher BMI and ALM/BMI ratios.
背景
糖尿病与肌肉质量和功能的下降有关，增加了发生肌肉减少症的风险。因此，本研究旨在调查卡塔尔成年人（>18 岁）中肌肉减少症的发病几率及其相关危险因素，并探讨健康和生活方式因素的调节作用。
方法
采用病例对照设计，从卡塔尔生物库（QBB）中收集了 767 名参与者（481 名糖尿病患者为病例组，286 名无糖尿病患者为对照组）的数据。分析了社会人口统计学、生活方式因素，包括饮食摄入、人体测量和生化指标。握力、双能 X 线吸收法（DXA）和生物电阻抗分别用于评估肌肉力量、肌肉质量和肌肉质量。使用欧洲肌肉减少症定义和诊断共识来估计肌肉减少症的发病风险。
结果
与对照组相比，糖尿病患者年龄更大（55 岁 vs. 36 岁；P<0.001），BMI 更高（31.6 公斤/平方米 vs. 28.3 公斤/平方米；P<0.001），心肺功能更好（50.0%的病例组为“中等”健康，而对照组为 62.9%为“高”健康），且总能量（59.0% vs. 64.0%；P=0.004）和动物蛋白（39.0% vs. 42.0%；P=0.001）摄入量更少。根据计算得分，与对照组相比，糖尿病患者的四肢瘦体重/ BMI、握力和发生肌肉减少症/疑似肌肉减少症的概率也更低（P<0.005）。调整后的多因素逻辑回归显示，心肺功能提高（β=0.299，95%CI：0.12-0.74）和血液甘油三酯升高（β=1.475，95%CI：1.024-2.124），以及女性（β=0.086，95%CI：0.026-0.288）和 BMI 更高（β=0.908，95%CI：0.852-0.967）和四肢瘦体重/ BMI 更高（β=0.000，95%CI：0.000-0.007）是肌肉减少症风险的独立预测因素（p<0.05）。
结论
本研究强调了糖尿病和肌肉减少症之间的复杂关系，揭示了可改变的危险因素。与对照组相比，糖尿病患者发生肌肉减少症的可能性更高，这与较低的健康水平和较高的血液甘油三酯有关。预防肌肉减少症的保护因素包括女性、更高的 BMI 和四肢瘦体重/ BMI 比值。
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